Predictive power of Ki-67 antigen expression in patients with uveal melanomas

Cilj ove kratke studije bio je utvrditi izražajnost Ki-67 kao cimbenika proliferacije u stanicama melanoma srednje ocne ovojnice, ispitati je li intenzitet izražajnosti povezan s morfološkim tipom stanica, te utvrditi je li intenzitet izražajnosti u svezi sa stupnjem invazije, što bi moglo imati prognosticki znacaj. Za ispitivanje jacine izražajnosti Ki-67 proteina indirektnom peroksidaza-antiperoksidaza metodom i monoklonalnim antitijelom za Ki-67 protein pregledano je 30 melanoma srednje ocne ovojnice. Jacina izražajnosti reakcije je obilježena semikvantitativnom metodom kao: negativna, slabo pozitivna, umjereno i jako pozitivna. Imunološka reakcija je bila negativna u 3 melanoma vretenastih stanica i jednom epiteloidnih stanica, slabo pozitivna u 3 tumora vretenastih stanica; umjereno pozitivna u 6 tumora vretenastih stanica, 6 miješane grade i 3 epiteloidnih stanica. Reakcija je bila najjaceg intenziteta u jednom melanomu vretenastih stanica, 6 miješane grade i jednom epiteloidne grade. U našem uzorku tumora pT2 stadija vecina tumora pokazala je umjereno jaku reakciju (30%), a manji broj slabo pozitivnu (6,6%), ali u pT3 stadiju 26,7% tumora je pokazalo najjaci intenzitet reakcije.The aim of this short study was to investigate the expression of Ki-67 immunocomplex in uveal melanoma cells, to examine if the expression intensity corellates with the morphologic cell type, to establish if the expression intensity corellates with the invasion levels which would result in prognostic significance. 30 uveal melanomas were examined in order to test the presence of Ki-67 protein by indirect peroxidaseantiperoxidase method and monoclonal antibody for Ki-67 protein. The intensity of the reaction was marked negative, weakly positive, moderately positive or strongly positive by the semiquantitative method. The immunoreaction was found to be negative in 3 spindle cell melanomas and 1 epitheloid; weakly positive in 3 spindle cell melanomas, moderately positive in 6 spindle cell melanoma, 6 of mixed cellularity and 3 of epitheloid type. The intensity was strongest in 1 spindle cell, 6 tumors of mixed cellularity and one epitheloid. In our samples from the pT2 stage most tumors were moderately positive (30%), and a minor number of cases were weakly positive (6,6%), but in the pT3 stage 26,7% of tumors showed the strongest intensity of reaction

p - 16 INK4a as a marker for cervical dysplasia

U razdoblju 2002. – 2004. godine 58 bolesnika Poliklinike "Lozo" testirano je na HPV. 33 testirane osobe bile su negativne, a ostalih 25 pozitivno. 23 bolesnice su nastavile s lijecenjem, dok su ostale iskljucene iz daljnje obrade iz razlicitih razloga (odlazak u drugu ustanovu na lijecenje ili su izgubljene iz sustava pracenja). Nakon pripreme za imunohistokemijsku analizu s monoklonalnim mišjim protutijelom p-16INK4a (DAKO Cytomation, Danska) nakon demaskiranja antigena i vizualizacijskim sustavom EnVision TM etrogradno su pregledana 23 uzorka tkiva. Rezultati munohistokemijske analize prikazani su semi-kvantitativnom metodom od 0-3. 4 bolesnice su bile p-16INK4a negativne (1 je imala cervikalni polip, 3 šiljate kondilome rodnice bez atipija). Od 7 bolesnica s citološki dokazanim CIN I, 3 su pokazale negativnu reakciju na p-16, a ostale 4 fokalno pozitivnu reakciju u citoplazmi i jezgrama epitelnih stanica. Od 6 bolesnica s citološkim CIN II, 3 su bile negativne na bojenje s p-16, jedna je pokazala fokalno pozitivnu reakciju, dok su dvije imale jako izraženu pojavnost p-16INK4a. Jedna od 3 bolesnice s itološkim CIN III imala je negativnu reakciju, a ostale dvije pozitivnu reakciju jakog intenziteta. Jedina bolesnica s citološkim CIS imala je difuznu jako pozivnu reakciju s p-16INK4a. Od dvije bolesnice s nepoznatim rezultatom Papa-testa jednoj je patohistološki dijagnosticiran CIN I, a drugoj CIN III na konizatu, dok je reakcija na p-16INK4a bila fokalno pozitivna u citoplazmi epitelnih stanica. Iz rezultata je vidljivo da je p-16INK4a bio pozitivan u svim stupnjevima displazije i klinicki evidentnog karcinoma (69,5%), a HPV je dokazan u svih bolesnica s citološkim CIN III. Stoga ova dva pokazatelja treba koristiti u preventivnim programima, uz ostale do sada poznate metode, jer omogucuju brzo, jednostavno i sigurno dokazivanje stupnja displazije.In the period 2002-2004, 58 patients from Lozo Health Center were tested for HPV, 25 of them were HPV positive, 33 negative. 23 patients continued with medical treatment, while the others were excluded from treatment (went to other institutions or their follow-up forms had been lost). After being prepared for immunohistochemical examination, all 23 tissue samples underwent retrograde immunohistochemical analysis with monoclonal mouse antibody p-16INK4a (DAKO Cytomation, Denmark) after antigen demasking and coupled with the DAKO En Vision TM visualisation system. The results of immunohistochemical analysis were presented with semiquantitative score system from 0- 3. Four patients were p-16INK4a negative (1 with cervical polyp and 3 vulvar condylomata without dysplasia.). Three from seven patients with cytologic CIN I were p-16 negative, while the remaining four showed focally positive expression in the cytoplasm and nuclei of epithelial cells. 3 patients out of 6 with cytologically evident CIN II showed negative reaction with -16, 1 focally positive reaction, while two were strongly showing p-16INK4a. In 1 case from 3 patients with CIN III p-16 had negative expression, while the other two showed a strongly positive xpression. The only case with cytologic CIS had a diffuse and positive reaction with p-16INK4a. 1 from 2 patients with an unknown Papa-test result was diagnosed CIN IHPV negative), while the other was diagnosed CIN III on the cervical conus, and p-16INK4a expression was focally positive in the cytoplasm of epithelial cells. From our results it is evident that p-16INK4a was positive in all tages of cervical dysplasia and clinically evident carcinoma CIS 69,5%),and HPV was confirmed with patients with CIN III. These two markers can therefore be used in prevention programmes with other currently known methods for they enable quick, simple and secure proof of the degree of dysplasia

Neuroendocrine carcinoma of the posterior mediastinum - a case report

Prikazan je slucaj 64-godišnjeg bolesnika s tumorom stražnjeg gornjeg medijastinuma uz racvište dušnika. Mikroskopski, tumor je graden od angiocentricno poredanih otoka stanica koje su na periferiji visoke, cilindricne, te stvaraju Flexner-Wintersteiner rosete i palisade, dok su u središtu poligonalne, s bizarnim multilobuliranim oblicima jezgri, visokom mitotickom aktivnošcu i znatnom nekrozom. Grimelius metodom dokazana su argentafilna tjelešca u jezgri. Imunohistokemijski, tumorske stanice su izrazito pozitivne na epitelne i neuroendokrine markere EMA, Cytokeratin MNF-116, NSE, S-100 i Chromogranin-A, dok su CD-99, TTF-1, Vimentin i p-21 negativne. Obzirom na opisanu histološku sliku, tumor je dijagnosticiran kao rijetki primarni neuroendokrini karcinom velikih stanica smješten u stražnjem gornjem medijastinumu.A tumor mass was noted in the posterior mediastinum on the tracheal bifurcation in a 64-year- old man. Microscopically the tumor consisted of angiocentric atypical cylindrical epithelial cells that often form Flexner-Wintersteiner rosette and palisade. In the centre of the tumor island the cells were polygonal and showed bizzare multinucleated nuclei with marked necrosis and mitotic activity. The argentafillic bodies were identified by the Grimelius method. Immunohistochemically, the tumor cells expressed both epithelial and neuroendocrine markers, including Cytokeratin MNF-116, EMA, NSE, S-100, Synaptophysin and Chromogranin A; while CD-99, TTF-1, Vimentin, p-21 were negative. The described tumor was diagnosed as a rare, primary neuroendocrine carcinoma of large cells in the upper posterior me

Nefunkcio nalni karcinom paratiroidne žlijezde : prikaz slučaja

Parathyroid gland carcinoma is a rare malignancy. The tumor is mostly functioning, causing severe hyperparathyroidism, with high serum calcium level and severe bone disease. Non-functioning parathyroid carcinomas are extremely rare. We report on a 60-year-old male patient admitted to ENT Department due to a large neck tumor mass compressing the thyroid and trachea. Preoperatively, thyroid hormone, parathyroid hormone (PTH ) and calcium serum levels were normal. The following immunohistochemical markers (DAKO, Denmark) were used: bcl-2; CD- 10; Chromogranin-A; Cyclin-D1; EM A; Ki-67; Mdm-2; p-53; PGP-9,5; RCC; Synaptophysin; Thyroglobulin; and TTF -1. Immunohistochemical analysis indicated the diagnosis of a primary parathyroid gland carcinoma. Tumor cells showed diffusely positive immunohistochemical staining with chromogranin-A and PGP-9,5, positive staining of variable intensity with synaptophysin, and weakly positive reaction with EM A. Also, the cytoplasm of tumor cells was diffusely positively stained with bcl-2, while the nuclei showed positive reaction with p-53 oncogene and TTF -1. The remaining markers (CD-10, cyclin-D1, Ki-67, Mdm-2, RCC and thyroglobulin) were negative. Four years after the surgery, the patient died from renal carcinoma pulmonary metastases and liver cirrhosis complications. In conclusion, non-functioning parathyroid gland carcinoma is a very rare disease. Detailed immunohistochemical analysis is needed to distinguish it from other thyroid and parathyroid neoplasms and metastatic carcinoma. Surgical treatment is presently the best mode of therapy.Karcinom paratiroidne žlijezde je rijedak maligni tumor. Tumor je najčešće hormonski aktivan i uzrokuje teški oblik hiperparatiroidizma s visokom serumskom razinom kalcija, poremećajima koštane gustoće i bubrežnim kamencima. Nefunkcionalni paratiroidni karcinom je iznimno rijedak. Prikazuje se slučaj 60-godišnjeg bolesnika koji je primljen na Odjel otorinolaringologije zbog velikog tumora vrata koji je komprimirao grkljan i dušnik. Prijeoperacijski su serumske vrijednosti hormona štitnjače, paratiroidnog hormona i kalcija bile unutar referentnih vrijednosti. Korišteni su slijedeći imunohistokemijski biljezi: (DAKO, Danska): bcl-2; CD-10; Chromogranin-A; Cyclin-D1; Ki-67; Mdm-2; p-53; RCC; Synaptophysin; Thyroglobulin i TTF -1. Imunohistokemijskom analizom tumora postavljena je dijagnoza primarnog karcinoma paratiroidne žlijezde. Tumorske stanice su pokazale difuzno pozitivnu imunoreakciju s kromograninom i PGP- 9,5, pozitivnu reakciju različitog intenziteta sa sinaptofizinom, te slabo pozitivnu reakciju na EM A. U citoplazmi je nađena umjereno pozitivna reakcija na bcl-2, a jezgre su bile pozitivne na p-53 i TTF -1, dok su ostali biljezi bili nereaktivni. Četiri godine nakon operacije bolesnik je umro od posljedica plućnih metastaza karcinoma bubrega i dekompenzirane jetrene ciroze. U zaključku, nefunkcionalni karcinom paratiroidne žlijezde je vrlo rijedak i težak za dijagnosticiranje. Detaljnim imunohistokemijskim metodama potrebno ga je diferencirati od ostalih tumora štitne i paratiroidne žlijezde i metastatskog karcinoma. Kirurško liječenje danas predstavlja optimalan oblik terapije

Nefunkcio nalni karcinom paratiroidne žlijezde : prikaz slučaja

Parathyroid gland carcinoma is a rare malignancy. The tumor is mostly functioning, causing severe hyperparathyroidism, with high serum calcium level and severe bone disease. Non-functioning parathyroid carcinomas are extremely rare. We report on a 60-year-old male patient admitted to ENT Department due to a large neck tumor mass compressing the thyroid and trachea. Preoperatively, thyroid hormone, parathyroid hormone (PTH ) and calcium serum levels were normal. The following immunohistochemical markers (DAKO, Denmark) were used: bcl-2; CD- 10; Chromogranin-A; Cyclin-D1; EM A; Ki-67; Mdm-2; p-53; PGP-9,5; RCC; Synaptophysin; Thyroglobulin; and TTF -1. Immunohistochemical analysis indicated the diagnosis of a primary parathyroid gland carcinoma. Tumor cells showed diffusely positive immunohistochemical staining with chromogranin-A and PGP-9,5, positive staining of variable intensity with synaptophysin, and weakly positive reaction with EM A. Also, the cytoplasm of tumor cells was diffusely positively stained with bcl-2, while the nuclei showed positive reaction with p-53 oncogene and TTF -1. The remaining markers (CD-10, cyclin-D1, Ki-67, Mdm-2, RCC and thyroglobulin) were negative. Four years after the surgery, the patient died from renal carcinoma pulmonary metastases and liver cirrhosis complications. In conclusion, non-functioning parathyroid gland carcinoma is a very rare disease. Detailed immunohistochemical analysis is needed to distinguish it from other thyroid and parathyroid neoplasms and metastatic carcinoma. Surgical treatment is presently the best mode of therapy.Karcinom paratiroidne žlijezde je rijedak maligni tumor. Tumor je najčešće hormonski aktivan i uzrokuje teški oblik hiperparatiroidizma s visokom serumskom razinom kalcija, poremećajima koštane gustoće i bubrežnim kamencima. Nefunkcionalni paratiroidni karcinom je iznimno rijedak. Prikazuje se slučaj 60-godišnjeg bolesnika koji je primljen na Odjel otorinolaringologije zbog velikog tumora vrata koji je komprimirao grkljan i dušnik. Prijeoperacijski su serumske vrijednosti hormona štitnjače, paratiroidnog hormona i kalcija bile unutar referentnih vrijednosti. Korišteni su slijedeći imunohistokemijski biljezi: (DAKO, Danska): bcl-2; CD-10; Chromogranin-A; Cyclin-D1; Ki-67; Mdm-2; p-53; RCC; Synaptophysin; Thyroglobulin i TTF -1. Imunohistokemijskom analizom tumora postavljena je dijagnoza primarnog karcinoma paratiroidne žlijezde. Tumorske stanice su pokazale difuzno pozitivnu imunoreakciju s kromograninom i PGP- 9,5, pozitivnu reakciju različitog intenziteta sa sinaptofizinom, te slabo pozitivnu reakciju na EM A. U citoplazmi je nađena umjereno pozitivna reakcija na bcl-2, a jezgre su bile pozitivne na p-53 i TTF -1, dok su ostali biljezi bili nereaktivni. Četiri godine nakon operacije bolesnik je umro od posljedica plućnih metastaza karcinoma bubrega i dekompenzirane jetrene ciroze. U zaključku, nefunkcionalni karcinom paratiroidne žlijezde je vrlo rijedak i težak za dijagnosticiranje. Detaljnim imunohistokemijskim metodama potrebno ga je diferencirati od ostalih tumora štitne i paratiroidne žlijezde i metastatskog karcinoma. Kirurško liječenje danas predstavlja optimalan oblik terapije

Metastaza karcinoma bubrega u nosno-sinusnoj šupljini

Renal cell carcinoma accounts for 3% of all adult malignant tumors. Common sites of metastases are lungs, bone, liver, brain and adrenal glands. Metastatic disease to the head and neck ranges from 15% to 30%. The 5-year survival rate after nephrectomy is 60%-75%, but with multiorgan metastases the 5-year survival rate is significantly lower, 0-7%. A case is presented of a female patient diagnosed with renal cell carcinoma metastases to the paranasal sinuses, diagnosed and treated at the Department of ENT and Head and Neck Surgery, Zadar General Hospital, Zadar, Croatia. The tumor was surgically removed. Unfortunately, the patient died one year after the procedure due to multiorgan failure. Although metastases of renal cell carcinoma to the head and neck are very rare, it should be first suspected when investigating a metastatic tumor in this region. Surgical excision offers the best hope for long term survival. In case of unresectable tumor, other treatment options should be considered such as radiotherapy, immunotherapy and chemotherapy.Od svih malignih tumora ljudskog organizma tumor bubrega je zastupljen u oko 3% slučajeva. Česta mjesta metastaziranja su pluća, kosti, jetra, mozak i nadbubrežna žlijezda. Pojava metastaza ovoga karcinoma u području glave i vrata kreće se oko 15%-30%. Postotak petogodišnjeg preživljenja nakon nefrektomije je 60%-75%, dok je istovjetno preživljenje s prisutnim metastazama znatno kraće, 0-7%. U ovom radu prikazuje se bolesnica kojoj je dijagnosticiran karcinom bubrega s metastazom u nosnoj šupljini i paranazalnim sinusima. Dijagnostički postupak i kirurško liječenje obavljeno je u Općoj bolnici Zadar, Odjel otorinolaringologije i kirugije glave i vrata. Tumor je uspješno kirurški odstranjen, ali je bolesnica preminula nakon godinu dana zbog višeorganskih metastaza. Metastaza bubrežnog karcinoma u području glave i vrata je vrlo rijetka. Kirurška ekscizija je metoda izbora, a u slučaju neresektabilnog tumora moguće je primijeniti radioterapiju, imunoterapiju i kemoterapiju

Alzheimer and Lewy body pathology or Creutzfeldt-Jakob disease

he objective of this work is to describe the neuropathological findings of a patient clinically presenting with rapidly progressive nonspecific neurological symptoms suggestive of Creutzfeldt-Jakob disease. Methods used were clinical description with laboratory analyses, repeated electroencephalogram, cerebral computed tomography, magnetic resonance imaging studies and details on neuropathological work-up. Neuropathological examination excluded Creutzfeldt-Jakob disease. By contrast other neurodegenerative changes combining Alzheimer-type pathology and Lewy body pathology were detected as the most likely substrate of neurological symptoms. Dementia with Lewy bodies should be included in the differential diagnosis in individuals presenting with rapidly progressive dementia

Alzheimer and Lewy body pathology or Creutzfeldt-Jakob disease

he objective of this work is to describe the neuropathological findings of a patient clinically presenting with rapidly progressive nonspecific neurological symptoms suggestive of Creutzfeldt-Jakob disease. Methods used were clinical description with laboratory analyses, repeated electroencephalogram, cerebral computed tomography, magnetic resonance imaging studies and details on neuropathological work-up. Neuropathological examination excluded Creutzfeldt-Jakob disease. By contrast other neurodegenerative changes combining Alzheimer-type pathology and Lewy body pathology were detected as the most likely substrate of neurological symptoms. Dementia with Lewy bodies should be included in the differential diagnosis in individuals presenting with rapidly progressive dementia

LUXATION OF PRIMARY AND PERMANENT TEETH

Ozljede zuba su jedne od najčešćih ozljeda orofacijalne regije tijekom djetinjstva. Luksacijske ozljede mliječnih i trajnih zuba predstavljaju indikaciju za hitno liječenje. Mnoge od tih ozljeda nastaju iz predvidivih aktivnosti i na njih se moţe preventivno djelovati. Bitan podatak iz anamneze je i mehanizam ozljede te kod ozljeda izazvanih velikim silama treba misliti na ozljedu glave i/ili vrata. Luksacijske ozljede su luksacija, subluksacija, ekstruzija, lateralna luksacija, intruzija i avulzija. Kod većine dolazi do ozljede periodontalnog ligamenta (PDL-a). Cilj je liječenja omogućiti cijeljenje PDL-a i očuvati vitalitet pulpe kad god je to moguće. Prekid vaskularne opskrbe pulpe i bakterije mogu negativno utjecati na ishod liječenja. Nekrotično tkivo pulpe u korijenu kanala moţe aktivirati upalne resorpcijske procese koji uništavaju korijen. Nakon ozljeda mliječnih zuba treba uvijek misliti na sigurnost trajne denticije, a uspjeh terapije ovisi i o suradnji djeteta i roditelja, ali i znanju i vještini stomatologa. Još uvijek se rjeĎe traţi stomatološko liječenje za luksacijske ozljede mliječnih zuba jer roditelji misle kako je njihova funkcija prolazna. Roditelje treba upoznati o ozljedi i njenom utjecaju na trajne zube i potrebi kontinuiranog nadzora.Tooth injuries are one of the most common injuries of the orofacial region in childhood. Luxation injuries of primary and permanent teeth are an indication for emergency treatment. Many of these injuries arise from foreseeable activities and can be prevented. Important information from the anamnesis is the mechanism of the injury and in the case of injuries caused by high forces one should bear in mind the injury to the head and/or neck. Luxation injuries are luxation, subluxation, extrusion, lateral luxation, intrusion and avulsion. Most of them have a periodontal ligament (PDL) injury. The goal of the treatment is to enable the healing of PDL and to preserve pulp vitality whenever possible. Disruption of the vascular supply of the pulp and bacteria can adversely affect the outcome of the treatment. Necrotic pulp tissue in the root canal can activate inflammatory resorption processes which destroy the root. After injuries of the primary teeth, the safety of permanent dentition should always be considered, and the success of the therapy depends on the cooperation of the child and the parents, as well as the knowledge and skills of the dentist. Dental treatment for luxation injuries of primary teeth is still rarely sought because parents think their function is transient. Parents should be informed of the injury and its possible effect on the permanent teeth as well as the need for ongoing monitoring

p - 16 INK4a as a marker for cervical dysplasia

U razdoblju 2002. – 2004. godine 58 bolesnika Poliklinike "Lozo" testirano je na HPV. 33 testirane osobe bile su negativne, a ostalih 25 pozitivno. 23 bolesnice su nastavile s lijecenjem, dok su ostale iskljucene iz daljnje obrade iz razlicitih razloga (odlazak u drugu ustanovu na lijecenje ili su izgubljene iz sustava pracenja). Nakon pripreme za imunohistokemijsku analizu s monoklonalnim mišjim protutijelom p-16INK4a (DAKO Cytomation, Danska) nakon demaskiranja antigena i vizualizacijskim sustavom EnVision TM etrogradno su pregledana 23 uzorka tkiva. Rezultati munohistokemijske analize prikazani su semi-kvantitativnom metodom od 0-3. 4 bolesnice su bile p-16INK4a negativne (1 je imala cervikalni polip, 3 šiljate kondilome rodnice bez atipija). Od 7 bolesnica s citološki dokazanim CIN I, 3 su pokazale negativnu reakciju na p-16, a ostale 4 fokalno pozitivnu reakciju u citoplazmi i jezgrama epitelnih stanica. Od 6 bolesnica s citološkim CIN II, 3 su bile negativne na bojenje s p-16, jedna je pokazala fokalno pozitivnu reakciju, dok su dvije imale jako izraženu pojavnost p-16INK4a. Jedna od 3 bolesnice s itološkim CIN III imala je negativnu reakciju, a ostale dvije pozitivnu reakciju jakog intenziteta. Jedina bolesnica s citološkim CIS imala je difuznu jako pozivnu reakciju s p-16INK4a. Od dvije bolesnice s nepoznatim rezultatom Papa-testa jednoj je patohistološki dijagnosticiran CIN I, a drugoj CIN III na konizatu, dok je reakcija na p-16INK4a bila fokalno pozitivna u citoplazmi epitelnih stanica. Iz rezultata je vidljivo da je p-16INK4a bio pozitivan u svim stupnjevima displazije i klinicki evidentnog karcinoma (69,5%), a HPV je dokazan u svih bolesnica s citološkim CIN III. Stoga ova dva pokazatelja treba koristiti u preventivnim programima, uz ostale do sada poznate metode, jer omogucuju brzo, jednostavno i sigurno dokazivanje stupnja displazije.In the period 2002-2004, 58 patients from Lozo Health Center were tested for HPV, 25 of them were HPV positive, 33 negative. 23 patients continued with medical treatment, while the others were excluded from treatment (went to other institutions or their follow-up forms had been lost). After being prepared for immunohistochemical examination, all 23 tissue samples underwent retrograde immunohistochemical analysis with monoclonal mouse antibody p-16INK4a (DAKO Cytomation, Denmark) after antigen demasking and coupled with the DAKO En Vision TM visualisation system. The results of immunohistochemical analysis were presented with semiquantitative score system from 0- 3. Four patients were p-16INK4a negative (1 with cervical polyp and 3 vulvar condylomata without dysplasia.). Three from seven patients with cytologic CIN I were p-16 negative, while the remaining four showed focally positive expression in the cytoplasm and nuclei of epithelial cells. 3 patients out of 6 with cytologically evident CIN II showed negative reaction with -16, 1 focally positive reaction, while two were strongly showing p-16INK4a. In 1 case from 3 patients with CIN III p-16 had negative expression, while the other two showed a strongly positive xpression. The only case with cytologic CIS had a diffuse and positive reaction with p-16INK4a. 1 from 2 patients with an unknown Papa-test result was diagnosed CIN IHPV negative), while the other was diagnosed CIN III on the cervical conus, and p-16INK4a expression was focally positive in the cytoplasm of epithelial cells. From our results it is evident that p-16INK4a was positive in all tages of cervical dysplasia and clinically evident carcinoma CIS 69,5%),and HPV was confirmed with patients with CIN III. These two markers can therefore be used in prevention programmes with other currently known methods for they enable quick, simple and secure proof of the degree of dysplasia